Bottio Tomaso, Tarzia Vincenzo, Dal Lin Carlo, Buratto Edward, Rizzoli Giulio, Spina Michele, Gandaglia Alessandro, Naso Filippo, Gerosa Gino
Cardiovascular Institute, University of Padova, Italy.
J Heart Valve Dis. 2010 Jul;19(4):485-91.
The most effective method for decellularization of the intact porcine aortic root remains controversial. Additionally, the hydrodynamic effect that such treatment may have on aortic roots has never been previously investigated. The study aim was to compare the in-vitro hydrodynamic performances of intact porcine aortic roots, both before and after decellularization treatment.
Fifteen fresh porcine aortic roots were tested in the aortic chamber of the Sheffield pulse duplicator (SPD). For study purposes, the roots were first sutured to a silicone aortic root and then hydrodynamically tested. After in-vitro testing, the fresh porcine aortic roots, while still fixed within the silicone root, were decellularized according to various protocols (TRI-COL, TRI-DOC, sodium dodecyl sulfate (SDS) 0.03%, and SDS 0.1%). After decellularization, the valve roots were re-tested, adopting identical testing conditions. Forward flow pressure drop, closing leakage volumes, effective orifice area (EOA), and stroke work loss were each monitored. Three roots, used as a control group, were tested in identical fashion before and after storage (without decellularization) for comparative purposes.
The TRI-COL- and TRI-DOC-treated porcine aortic roots showed significantly lower transvalvular gradients, lower stroke work loss, lower valve resistance, and higher EOA than fresh intact porcine roots. In contrast, SDS 0.1%-treated porcine aortic roots showed opposing results, with the transvalvular gradients, stroke work loss and valve resistance each higher, and the EOA lower, than pre-treatment values. SDS 0.03% treatment had no significant effect on the hydrodynamic performance. After decellularization in all treatment groups, the diastolic parameters, total regurgitant volume and valve closing volume were each non-significantly increased. The aortic roots used as a control group showed similar results before and after storage.
Based on these results using the SPD, all treatments except for SDS 0.03% modified the systolic and diastolic functions of intact porcine aortic roots.
完整猪主动脉根部去细胞化的最有效方法仍存在争议。此外，此前从未研究过这种处理对主动脉根部可能产生的流体动力学效应。本研究旨在比较完整猪主动脉根部在去细胞化处理前后的体外流体动力学性能。
在谢菲尔德脉冲复制器（SPD）的主动脉腔中对15个新鲜猪主动脉根部进行测试。为便于研究，首先将根部缝合到硅胶主动脉根部，然后进行流体动力学测试。体外测试后，仍固定在硅胶根部内的新鲜猪主动脉根部按照不同方案（TRI - COL、TRI - DOC、0.03%十二烷基硫酸钠（SDS）和0.1% SDS）进行去细胞化处理。去细胞化后，在相同测试条件下对瓣膜根部重新进行测试。监测正向流动压降、关闭时漏血容积、有效瓣口面积（EOA）和每搏功损失。作为对照组的三个根部，在储存前后（未进行去细胞化）以相同方式进行测试以作比较。
与新鲜完整猪根部相比，经TRI - COL和TRI - DOC处理的猪主动脉根部显示出显著更低的跨瓣压差、更低的每搏功损失、更低的瓣膜阻力和更高的EOA。相比之下，经0.1% SDS处理的猪主动脉根部结果相反，其跨瓣压差、每搏功损失和瓣膜阻力均高于处理前值，而EOA更低。0.03% SDS处理对流体动力学性能无显著影响。在所有处理组去细胞化后，舒张期参数、总反流容积和瓣膜关闭容积均无显著增加。作为对照组的主动脉根部在储存前后结果相似。
基于使用SPD的这些结果，除0.03% SDS外，所有处理均改变了完整猪主动脉根部的收缩和舒张功能。
